Date:
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Position Applied For:
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Salary Expected:
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Name:
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Phone:
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Zip Code:
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Is any information about a change of name necessary to enable us to check work or school records? If yes, give name:
Type of Employment Sought:
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urs available:
Has Reality House, Inc. ever employed you?
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Do you have any relative(s) currently employed by Reality House, Inc.? If yes, give name(s), relationship(s) and department(s):
(Having relatives employed by Reality House, Inc. does not necessarily exclude an applicant from employment.)
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TO OUR APPLICANT:
We appreciate your interest in seeking employment with Reality House, Inc. ("RHI") and assure you that we are
sincerely interested in pursuing your application for employment. A clear understanding of your skills and work
history will aid us in considering you for the position for which you are applying. When completed, this application
will remain active for a period of 3 years. After that period of time, your application will become inactive, but you
may renew your interest in Reality House, Inc. by completing a new application form.
Reality House, Inc. complies with the Immigration Reform Act of 1986, under which we are required to verify your
legal identity and legal right to work in the U.S.A. if you are hired. Reality House, Inc. also complies with the Civil
Rights Act of 1964 and 1991 and Federal, state and city legislation which prohibit discrimination in employment
related decisions because of a person’s race, color, creed, ancestry, religion, citizenship status, gender, gender
identity or self-image, gender appearance, behavior or expression, or transgender status, national origin, political
belief, marital status, sexual orientation, disability, age or veteran status. However, certain laws require that we only
employ persons who meet legal age requirements for certain positions. In addition, Reality House, Inc. maintains
compliance with the provisions of the Americans with Disabilities Act of 1990 and the regulations promulgated
thereunder. To assist us in implementing that Act we will need to determine your ability to perform the essential
functions of the position for which you are being considered. Your truthful and honest responses as to whether you
have the ability to perform essential job functions, with or without reasonable accommodation, will aid Reality
House, Inc. in identifying possible reasonable accommodations which may assist in your job performance.
If employed by Reality House Inc., you will be asked to provide information such as your marital status, race, sex,
date of birth, dates of education, and U.S. citizenship or visa status for recordkeeping requirements of Reality House,
Inc. and/or Federal, state and city laws and benefits administration.
